• Imaging Science in Dentistry
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• 제46권3호
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• pp.159-165
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• 2016

Purpose: The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods: Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results: In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion: CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

• Imaging Science in Dentistry
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• 제46권2호
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• pp.69-75
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• 2016

Purpose: Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results: An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, $1.1{\pm}0.8mm$). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion: In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.

• Imaging Science in Dentistry
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• 제39권2호
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• pp.81-87
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• 2009

Purpose: To evaluate the anteroposterior length and buccal angle of the anterior loop, and the size and location of the mental foramen using cone beam computed tomography (CBCT). Materials and Methods: 100 CBCT images from 87 adults (43 males and 44 females) ranging in age from 20 to 73 years (average 50 years) with edentulous ridge of the mandibular premolar region were obtained. Axial, sagittal, coronal images were reconstructed from Dental and Block Images of CBCT. The anteroposterior length, shape and buccal angle of the anterior loop, and the size and location of the mental foramen were calculated from reconstructed images of axial, sagittal and coronal CBCT. Results: The anteroposterior length and buccal angle of the mental canal was 4.0${\pm}$1.2mm, 37.8${\pm}$11.60$^{\circ}$respectively. The loop type with straight course was the most common shape of the mental canal. The location of the mental foramen below the apex of the lower second premolar (78%) was the most common. The maximum size of the mental foramen was 4.6${\pm}$1.0 mm in width and 3.0${\pm}$0.6 mm in height. The inner size of the mental canal was 2.6${\pm}$0.6 mm in width and 2.1 mm${\pm}$0.4 mm in height. Conclusion: CBCT is useful to evaluate the anterior loop and mental foramen of the mandibular canal. Safe guideline of 4 mm from the most anterior point of the mental foramen is recommended for implant and surgical treatment. (Korean J Oral Maxillofac Radiol 2009; 39: 81-7)

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.30.1-30.6
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• 2018

Background: The purpose of the present study was to investigate the differences in the position and shape of the anterior loop of the inferior alveolar nerve (ALIAN) in relation to the growth pattern of the mandibular functional subunit. Methods: The study was conducted on 56 patients among those who had undergone orthognathic surgery at the Gangnam Severance Hospital between January 2010 and December 2015. Preoperative computerized tomography (CT) images were analyzed using the Simplant OMS software (ver.14.0 Materialise Medical, Leuven, Belgium). The anterior and inferior lengths of ALIAN (dAnt and dInf) and each length of the mandibular functional subunits were measured. The relationship between dAnt, dInf, and the growth pattern of the mandibular subunits was analyzed. Results: The length of the anterior portion of ALIAN (dAnt) reached 3.34 ± 1.59 mm in prognathism and 1.00 ± 0.97 mm in retrognathism. The length of the inferior portion of ALIAN (dInf) reached 6.81 ± 1.33 mm in prognathism and 5.56 ± 1.34 mm in retrognathism. The analysis of Pearson's correlation coefficiency on all samples showed that the lengths of functional subunits were positively correlated with the loop depth. The length of the symphysis area in prognathic patients was positively correlated with the anterior loop depth (p = 0.005). Conclusions: Both the anterior and inferior length of ALIAN are longer in prognathic patients. Especially, it seems to be associated with the growth of the symphysis area.

• Knee surgery & related research
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• 제30권4호
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• pp.341-347
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• 2018

Purpose: Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening. Materials and Methods: Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L'Insalata's method. Functional outcome was measured at 2-year follow-up. Results: The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups. Conclusions: The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices. Level of Evidence: Level 3, Retrospective Cohort.

• The Journal of Advanced Prosthodontics
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• 제9권6호
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• pp.470-475
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• 2017

PURPOSE. The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS. Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posterior-superior and lateral-superior direction. RESULTS. The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately $50^{\circ}$ posterior-superior and $41^{\circ}$ lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION. These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.

• 대한치과교정학회지
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• 제25권1호
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• pp.73-85
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• 1995

교정치료시 치축의 개선을 위한 많은 연구와 노력이 이루어져 왔다. 본 교실에서는 치축개선을 위해 MEAW를 응용한 Multi-Vertical Loop Arch Wire(MVLAW : 엠빌로)를 수년 전부터 다수치아의 치축을 동시에 개선코자 사용해 왔다. MVLAW는 일종의 근심경사된 치아를 세우는 장치로써 open vertical loop를 3가지 종류로 변형시켜 적용시켜 왔으며 이를 각각 A, B, C형으로 명명하였다. 각 MVLAW는 .017"x.025" TMAwire로 제작되며, A형 MVLAW의 경우 각 open vertical loop의 apex를 10도 정도 벌려주어 활성화시키며(electric welding stop을 각 loop의 근심측에 위치시킨다), B형과 C형 MVLAW의 경우 open vertical loop의 원심측에 10도의 tip back bend를 형성함으로써 활성화시킨다(B형의 경우 electric welding stop이 각 loop의 원심측에 형성되는 반면 C형의 경우 electric welding stop을 형성하지 않는다). 본 연구는 구치부의 치축을 동시에 개선코자할 때 MVLAW를 3가지 종류로 분류한 후 각 MVLAW의 효과를 알아보고자 상하악 1/2악을 광탄성 모형에 재현하여 그 응력분포를 관찰하여 다음과 같은 결론을 얻었기에 보고하는 바이다. 1. A형 MVLAW의 경우 3급 견인고무를 걸지 않았을 경우 하악 제1대구치와 제2대구치 치근의 원심면에서 강한 응력분포를 나타내나 전치부에 발생한 미약한 응력분포는 3급 견인고무의 장착으로 상쇄되었다. 따라서 A형 MVLAW는 초기에 치관의 직립효과가 있는 것으로 보인다. 2. B형 MVLAW의 경우 3급 견인고무를 걸지 않았을 경우 각 치아의 근심측에 응력분포를 보이며 견인고무를 걸었을 때와 비교시 전치부에 증가된 응력분포를 보였다. 따라서 B형의 경우 초기에 치근의 직립효과가 있는 것으로 보인다. 3. C형 MVLAW의 경우 3급 견인고무를 걸지 않았을 경우 하악전치부를 제외하고는 응력분포를 나타내지 않았으나 견인고무를 걸었을 경우 주로 견치와 소구치 근심면에서 응력분포를 보였다. 따라서 C형의 경우 견인고무 사용시 초기에 견치와 소구치에서 치근의 직립효과가 있는 것으로 보인다.

• 구강회복응용과학지
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• 제27권3호
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• pp.317-326
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• 2011

이공과 하악관 전방고리는 악골의 외과적 술식에서 중요한 기준점이 된다. 이번 연구의 목적은 전산화단층촬영를 이용해 이공과 하악관 전방고리의 형태를 분석하고, 이를 임상에 적용하기 위함이다. 외과적 수술이 계획된 96명(남성 33명, 여성 63명, 연령범위 17 ~ 43세, 평균연령 $24.6{\pm}4.99$세)의 환자를 대상으로 전산화단층촬영을 시행하였다. 전산화단층촬영 방사선영상에서 이공의 수평적, 수직적 위치, 치근첨과의 거리를 측정하였고, 하악관 전방고리는 치근첨에서의 거리, 협측 측방각도를 측정하였다. 이공의 위치는 하악 제2소구치 하방이 81례(46.0%)로 가장 많았으며, 하악 제1소구치와 제2소구치사이에 존재하는 경우는 67례(38.0%)로, 하악 제2소구치와 제1대구치 사이에 존재하는 경우는 19례(10.2%)로 나타났다. 이공과 하악골 하연과의 평균거리는 $12.20{\pm}1.77$ mm, 이공과 치근첨과의 평균거리는 $5.16{\pm}0.98$ mm. 하악관 전방고리의 평균 길이는 $5.80{\pm}2.00$ mm로 나타났다. 하악관 전방고리에 대한 협측 각도는 $47.7{\pm}9.07^{\circ}$로 나타났다. 치근첨과 이공과의 거리는 파노라마 영상에서는 $5.16{\pm}0.98$ mm로 나타났고, 전산화단층촬영영상에서는 $6.2{\pm}3.07$ mm로 나타났다. 이공과 하악관의 평균거리는 $5.39{\pm}1.62$ mm로 나타났다. 임플란트를 포함한 악골의 외과적 술식에서 이신경의 손상 및 외과적 외상의 위험을 최소화하고 최적의 수술결과를 얻기 위해서는 이공과 하악관 전방고리의 형태와 위치에 대한 정확한 평가가 이뤄져야 한다. 전산화단층촬영 영상은 이러한 해부학적 구조를 찾는데 유용할 것으로 생각된다.

• 대한치과교정학회지
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• 제29권5호
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• pp.521-534
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• 1999

본 연구는 상악 견치, 상악 제 2 소구치, 상악 제 1 대구치의 유한요소 모델을 제작하였고, $0.018{\times}0.025$ 인치 Stainless steel wire를 고정원 강화를 위해 상악 제 2소구치와 제 1대구치에 위치시켰다. $0.017{\times}0.025$ 인치 T-loop spring의 전후방적 위치에 따른 응력 분포를 알아보기 위해 T-loop spring의 중간이 견치와 제 1대구치 거리의 중간에 위치하는 것과, 2mm전방에 위치하는 것, 2mm후방에 위치하는 것의 3가지 유한 요소모델을 제작하였다. 이 T-loop spring을 6mm 강제변위시켜 발생하는 힘을 각 치아에 적용시켰으며, 견치에서 발생하는 힘과 응력에 대하여 다음과 같은 결론을 얻었다. 1. 3가지 형태 모두에서 유사한 크기의 후방견인력을 보였다. 2. 3가지 형태 모두에서 유사한 크기와 비슷한 형태의 응력 분포를 보였다. 3. 3가지 형태 모두에서 회전 중심은 치근단 2/3 부분에 보였다. 4. 2mm 전방 위치된 T-loop spring과 2mm 후방 위치 된 T-loop spring에 각각 함입력과 정출력을 보이지만 그 크기가 작아서 응력 양상에 영향을 주지 못한다.

• Journal of Korean Neurosurgical Society
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• 제44권5호
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• pp.303-307
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• 2008

Objective: The authors reviewed clinical and radiological outcomes in patients with three column injury of the cervical spine who had undergone posterior cervical fixation using Nitinol shape memory alloy loop in the anterior-posterior combined approach. Materials: Nine patients were surgically treated with anterior cervical fusion using an iliac bone graft and dynamic plate-screw system, and the posterior cervical fixation using Nitinol shape memory loop ($Davydov^{TM}$) at the same time. A retrospective review was performed. Clinical outcomes were assessed using the Frankel grading method. We reviewed the radiological parameters such as bony fusion rate, height of iliac bone graft strut, graft subsidence, cervical lordotic angle, and instrument related complication. Results: Single-level fusion was performed in five patients, and two-level fusion in four. Solid bone fusion was presented in all cases after surgery. The mean height of graft strut was significantly decreased from $20.46{\pm}9.97mm$ at immediate postoperative state to $18.87{\pm}8.60mm$ at the final follow-up period (p<0.05). The mean cervical lordotic angle decreased from $13.83{\pm}11.84^{\circ}$ to $11.37{\pm}6.03^{\circ}$ at the immediate postoperative state but then, increased to $24.39{\pm}9.83^{\circ}$ at the final follow-up period (p<0.05). There were no instrument related complications. Conclusion: We suggest that the posterior cervical fixation using Nitinol shape memory alloy loop may be a simple and useful method, and be one of treatment options in anterior-posterior combined approach for the patients with the three column injury of the cervical spine.